Diagnostic markers of yersiniosis in patients with inflammatory bowel diseases

Abstract

Relevance. This study is related to the study of the etiology, pathogenesis and clinic of inflammatory bowel diseases (IBD). In a number of patients with IBD who are refractory to anti-inflammatory/immunosuppressive therapy, there are signs of current or transferred yersiniosis infection, not diagnosed by routine methods.Aim. According to the scientific literature and the results of our own research, to identify the presence and assess the nature of the influence of yersinia on the occurrence and development of IBD.Materials Methods. In our study, we conducted a bacteriological examination of feces by polymerase chain reaction (PCR) in patients with a diagnosis of IBD (UC and CD) in the acute phase (MMDAI ≥ 4 points for UC and Best index ≥ 150 points for CD), as well as immunological diagnostics using enzyme immunoassay (IFA) in the version of line-blotting (IB). Using the results obtained, clinical and instrumental semiotics were evaluated in subgroups of individuals suffering from IBD with confirmed yersiniosis ("IBD+ IER+") and without it ("IBC+ IER–"). We also assessed the role of intestinal infection by determining the effectiveness of initial antibacterial therapy in the treatment of exacerbation of IBD.Results. A significant part (in the case of our sample – 45%) of patients with IBD, when examined by high-tech methods, demonstrate the presence of markers of a transferred or current yersiniosis infection. Its role in the initiation and development of autoimmune intestinal inflammatory process requires further clarification.Conclusions. In 45% of patients with IBD, high-precision examination reveals markers of transferred or current yersiniosis infection. Routine clinical methods for the diagnosis of yersiniosis have low sensitivity and do not allow us to convincingly assess the role of this bacterial agent as a trigger factor for the onset or recurrence of IBD. There is a tendency for greater manifestation in the debut of IBD in patients with markers of systemic yersiniosis. The fact of improvement against the background of empirical antibacterial therapy in 24% of patients with IBD, achievement of early clinical remission in 57% of patients receiving antibiotic therapy, indicates a significant role of bacterial enterocolopathogens in the genesis of chronic intestinal inflammation in a number of patients.